McCrory’s turn on mental health

By The Daily News

Published: Wednesday, November 13, 2013 at 11:58 AM.

You can’t blame mental health advocates for being more than a little skeptical about the McCrory administration’s pledge to make the system work better. They’ve heard it all before, but the product fell far short of expectations.

That said, officials with the N.C. Department of Health and Human Services say they’re committed to getting it right. They deserve the chance.

Health and Human Services Secretary Aldona Wos has unveiled a plan that was very short on details, but she did promise the improvements would reduce the role that emergency rooms and jails have assumed due to a lack of services for people with mental illnesses and substance abuse problems.

Mental health care in North Carolina has long been underfunded and inadequately addressed. Attempts over the years to improve the dysfunctional system have often yielded results ranging from mediocre to disastrous.

The most famous of these “reforms” occurred in the early days of former Gov. Mike Easley’s administration. A push toward de-institutionalization was supposed to bring clients living with mental illnesses back into their own community, where — theoretically, anyway — they would receive care and support.

We all know how that turned out. It was costly, and many people fell through the cracks as a result of poor planning and a shortage of community-based services that were supposed to fill the gap. As a result, many mentally ill people in crisis wound up in jail or in a hospital emergency room. On top of that, a number of private companies that provided personal care workers to help people with mental illnesses or developmental disabilities live at home took advantage of the taxpayers by billing at much higher rates than they were entitled to.

Gov. Beverly Perdue, Easley’s successor, attempted to patch the problem but also had to cope with the worst effects of a drawn-out recession.

You can’t blame mental health advocates for being more than a little skeptical about the McCrory administration’s pledge to make the system work better. They’ve heard it all before, but the product fell far short of expectations.

That said, officials with the N.C. Department of Health and Human Services say they’re committed to getting it right. They deserve the chance.

Health and Human Services Secretary Aldona Wos has unveiled a plan that was very short on details, but she did promise the improvements would reduce the role that emergency rooms and jails have assumed due to a lack of services for people with mental illnesses and substance abuse problems.

Mental health care in North Carolina has long been underfunded and inadequately addressed. Attempts over the years to improve the dysfunctional system have often yielded results ranging from mediocre to disastrous.

The most famous of these “reforms” occurred in the early days of former Gov. Mike Easley’s administration. A push toward de-institutionalization was supposed to bring clients living with mental illnesses back into their own community, where — theoretically, anyway — they would receive care and support.

We all know how that turned out. It was costly, and many people fell through the cracks as a result of poor planning and a shortage of community-based services that were supposed to fill the gap. As a result, many mentally ill people in crisis wound up in jail or in a hospital emergency room. On top of that, a number of private companies that provided personal care workers to help people with mental illnesses or developmental disabilities live at home took advantage of the taxpayers by billing at much higher rates than they were entitled to.

Gov. Beverly Perdue, Easley’s successor, attempted to patch the problem but also had to cope with the worst effects of a drawn-out recession.

Now it’s Gov. Pat McCrory’s turn, and he has entrusted the job to Wos.

Wos said her department would better coordinate services and ensure that people can get the care they need — and will monitor whether the changes made decrease the burden on hospitals and law enforcement.

Budget constraints will make those promises more difficult to keep. If the administration’s intention is to outsource much of the oversight of that care, a more thorough oversight of spending — especially charges billed by contractors — must be a key component of any plan to improve mental health care in this state.

Advocates for the mentally ill are withholding judgment. What they know is that for far too long, North Carolina has failed its residents who depend on access to adequate mental health services. Jails and emergency room beds are unacceptable substitutes for a cohesive, well-run system that helps people get the care they need, when they need it.

A version of this editorial first appeared in the Wilmington Star-News, a Halifax Media Group newspaper.